Dusting Off the Shelf

Virtually everyone who learns I wrote this novel wants to know the story behind it. How does it come about that a doctor puts pen to paper to write a suspense thriller?

This just begs the question: why do people write?  Some want to proclaim their voices, some want to gain immortality, some want to win riches or fame, some want to voice personal pain, some want to chronicle their lives, some want to deny their lives, some want to vindicate their lives, and some just want to write because they like to write.  The number of reasons vary as much as the number of writers.

As for me, I humbly stumbled into this little project. Years ago I wrote a PhD thesis in health policy at Harvard that studied potential conflicts between the ethical norms of academic science and the financial incentives created by scientists’ engagement with for-profit industry. Once completed, the 273-page dissertation sat on my bookshelf, begging for publication, but my clinical responsibilities as a medical resident and then a young attending swallowed my time, energies, and attention. Meanwhile, the dissertation just sadly gathered dust.

Fast forward five years...  I left my job in Boston for a better position in the northern reaches of New England, but in so doing lost a special relationship, found myself separated from my friends, and ended up alone, isolated, living in a log cabin at the end of a long dirt road in the middle of the dark, deep, northern woods of New Hampshire.  

Although poetic, the setting was quite solitary, and nightly the dissertation sat on my bookshelf, mocking me to get to work and publish its results.  As time progressed, this challenge became merely ironic.  The data were too old for real academic interest, and the most interesting aspect of the entire project was not the actual analysis but its underlying theme: that human beings, even scientists, are merely mortal, responding to incentives as much as the next fellow.  

Furthermore,  I realized this insight was nothing new.  Sinclair Lewis understood this truth almost a century ago.  His novel, Arrowsmith, published in 1925, led to his receiving both the Pulitzer Prize in Fiction and the Nobel Prize in Literature (at that time the first for an American!).  He observed that the novel's protagonist, Martin Arrowsmith -- student, doctor, public health official, clinician, scientist -- was subject to all the challenges that every man or woman must face in modern society.  This medical Everyman, an idealist with the highest values, could only achieve what his human mortality might allow.

And this simple insight is true now, as it was 100-years ago:  put scientists in environments in which they will be rewarded for less-than-perfect behavior, and (guess what!) they will respond in less-than-perfect ways.  This says nothing about any one individual; it’s the group that – on average – will shift to a more colored, less objective point of view.

And I suppose that’s the point of the novel The First Days of August (beyond fun and entertainment, and several other secondary themes).

In other words, writ large, the incentives we create for our scientists – in total for the public institution of American science as a whole – will influence (nay, even control and direct) the nation’s scientific product that we get in return, and that for years to come.   This product will affect not only us – but it will affect our children, and our children’s children, and our children’s children’s children, ad infinitum.   

The foundations we pour now will impact the buildings of many future generations.

And that's the truth.



Read 986 times Last modified on Monday, 28 December 2015 17:07
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